Provider Demographics
NPI:1649684242
Name:INNIS, SHERRY APRIL (RD LDN)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:APRIL
Last Name:INNIS
Suffix:
Gender:F
Credentials:RD LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734-6778
Mailing Address - Country:US
Mailing Address - Phone:828-349-2081
Mailing Address - Fax:
Practice Address - Street 1:1830 LAKESIDE DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-6778
Practice Address - Country:US
Practice Address - Phone:828-349-2081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-12
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL003893133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered